Linear growth and puberty in childhood obesity: what is new?

Causal associations between childhood obesity and delayed puberty or height: a bidirectional two-sample Mendelian randomization study

OBJECTIVES

Childhood obesity is thought to influence pubertal development, according to observational studies. However, the exact causal relationship remains unclear due to the complexity of factors affecting pubertal development.

METHODS

To explore the association between exposure (childhood obesity) and outcome (delayed puberty, height), we utilized various methods, including inverse-variance weighted (IVW), weighted median, weighted mode, and MR Egger regression. Additionally, sensitivity analyses were conducted using MR-Egger, MR-PRESSO, Cochran's Q, and leave-one-out techniques to ensure the robustness of the results. Additionally, reverse MR analysis was conducted to explore potential reverse causation.

RESULTS

The IVW analysis revealed no significant genetic causal link between childhood obesity and delayed puberty or height (all p>0.05). In the reverse analysis, height had a causal association with childhood obesity (OR=0.85, 95 % CI=0.76-0.96). The Cochran's Q test highlighted heterogeneity in the results concerning childhood obesity and height (p<0.05). But the MR-Egger intercept and MR-PRESSO test confirmed no impact the results pleiotropic bias, supported by leave-one-out sensitivity analysis.

CONCLUSIONS

Our study found no significant genetic causal association between childhood obesity and delayed puberty or height. However, height was causally associated with childhood obesity. Future research should utilize advanced analytical methods to better understand the determinants of pubertal development.

Special considerations for the child with obesity: An Obesity Medicine Association (OMA) clinical practice statement (CPS) 2024

Background

This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) details assessment and management of the child with overweight or obesity. The term "child" is defined as the child between 2 and 12 years of age. Because children are in a continual state of development during this age range, we will specify when our discussion applies to subsets within this age range. For the purposes of this CPS, we will use the following definitions: overweight in the child is a body mass index (BMI) ≥ 85th and <95th percentile, obesity in the child is a BMI ≥95th percentile, and severe obesity is a BMI ≥120% of the 95th percentile.

Methods

The information and clinical guidance in this OMA Clinical Practice Statement are based on scientific evidence, supported by medical literature, and derived from the clinical perspectives of the authors.

Results

This OMA Clinical Practice Statement provides an overview of prevalence of disease in this population, reviews precocious puberty in the child with obesity, discusses the current and evolving landscape of the use of anti-obesity medications in children in this age range, discusses the child with obesity and special health care needs, and reviews hypothalamic obesity in the child.

Conclusions

This OMA Clinical Practice Statement on the child with obesity is an evidence based review of the literature and an overview of current recommendations. This CPS is intended to provide a roadmap to the improvement of the health of children with obesity, especially those with metabolic, physiological, psychological complications and/or special healthcare needs. This CPS addresses treatment recommendations and is designed to help the clinician with clinical decision making.